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Covid-19 的临床和传播特点——单胸外科 25 例回顾性研究。

Clinical and Transmission Characteristics of Covid-19 - A Retrospective Study of 25 Cases from a Single Thoracic Surgery Department.

机构信息

Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.

出版信息

Curr Med Sci. 2020 Apr;40(2):295-300. doi: 10.1007/s11596-020-2176-2. Epub 2020 Mar 30.

Abstract

The outbreak of corona virus disease 2019 (Covid-19) imposes a major challenge in managing patients undergoing surgical operation. In this study, we analyzed clinical and transmission features of 25 cases of Covid-19 from a single thoracic department, including 13 patients and 12 health care staff. There were 13 males and 12 females. The median age of the patients was 61 (range: 51 to 69) years. The median age of the health care staff was 35 (range: 22 to 51) years. By the end of follow-up date (Mar. 3, 2020), there were 16 non-severe cases (64%) and 9 severe cases (36%), 5 cases were dead (20%). Nineteen (76%) of the infected cases were confirmed by SARS-CoV-2 nucleic acid test, the rest were clinically diagnosed as suspected Covid-19 cases, and 19 (76%) of the infected cases had positive exposure history. We found that COPD was significantly associated with severity and death (P=0.040, and P=0.038, respectively), and chest operation was significantly associated with death for Covid-19 patients (P=0.039). A potential "super spreader" may be the source of the transmission before the implementation of quarantine and comprehensive protection. It was concluded that Covid-19 is associated with poor prognosis for patients undergoing thoracic operation, especially for those with COPD. Implementation of comprehensive protective measures is important to control nosocomial infection.

摘要

2019 年冠状病毒病(COVID-19)的爆发给接受手术的患者管理带来了重大挑战。在这项研究中,我们分析了来自单个胸科部门的 25 例 COVID-19 患者和 12 名医护人员的临床和传播特征。患者中有 13 名男性和 12 名女性。患者的中位年龄为 61 岁(范围:51-69 岁)。医护人员的中位年龄为 35 岁(范围:22-51 岁)。截至随访日期(2020 年 3 月 3 日),有 16 例非重症病例(64%)和 9 例重症病例(36%),5 例死亡(20%)。19 例(76%)感染病例通过 SARS-CoV-2 核酸检测确诊,其余为临床诊断疑似 COVID-19 病例,19 例(76%)感染病例有阳性接触史。我们发现 COPD 与严重程度和死亡显著相关(P=0.040 和 P=0.038),而胸部手术与 COVID-19 患者的死亡显著相关(P=0.039)。在实施隔离和全面保护措施之前,可能存在一个“超级传播者”是传播的源头。结论是 COVID-19 与接受胸部手术的患者预后不良相关,尤其是患有 COPD 的患者。实施全面的保护措施对于控制医院感染很重要。

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